Evaluation of Supplementary Prescribing in Nursing and Pharmacy

Nurse and pharmacist supplementary prescribing in England is safe and is acceptable to patients and doctors, whilst offering nurses and pharmacists enhanced job satisfaction and a useful introduction to prescribing. These findings emerged from a study conducted by the University of Sheffield and University of Nottingham into this new prescribing initiative, to explore barriers and facilitators to supplementary prescribing implementation, patient and professional experiences, prescribing practices and issues around the safety and costs of supplementary prescribing. Supplementary prescribing was introduced in the UK in 2003, enabling suitably trained nurses and pharmacists (and more recently other health care professionals) to prescribe a full range of medicines using clinical management plans after an initial medical diagnosis. The study involved key stakeholder interviews, surveys of nurse and pharmacist supplementary prescribers, analysis of PACT data, and a series of case study observations and follow-up interviews, including analysis of observed prescribing. The study concluded that supplementary prescribing consolidated nurses' existing practice but was an innovation in working practice for pharmacists, although non-medical prescribing remains at very low levels and a lack of understanding and awareness of supplementary prescribing was evident amongst doctors and patients. Clinical management plans were also criticised and were sometimes not used as intended in practice.